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NPI Code Detail

MEDICARE: TYNEAL SMITH FNP

MEDICARE: TYNEAL SMITH FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner11041917FL

General Provider Information

NPI Number : 1174402846
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYNEAL SMITH FNP
Provider Business Mailing Address
First Line : 1555 N PALAFOX ST
Second Line :
City : PENSACOLA
State : FL
Zip : 32501-2134
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1555 N PALAFOX ST
Second Line :
City : PENSACOLA
State : FL
Zip : 32501-2134
Country : US
Telephone Number : 850-890-7706
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2025
Last Update Date : 09/03/2025

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Directions to “ TYNEAL SMITH FNP” Practice Location

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